Achilles Tendinopathy

What is Achilles Tendinopathy?

A tendinopathy occurs when a tendon fails to heal after an overuse injury. This causes pain and swelling of the tendon and often results in a limp, lack of function and stiffness.

Achilles tendinopathy can affect the tendon where it inserts into the heel bone (insertional tendinopathy) or in its middle (mid-substance tendinopathy). This common tendinopathy seems to be becoming more common as people participate more in sports activities, particularly if they train heavily or incorrectly. It is seen particularly in runners and in those with abnormal foot posture.

How is Achilles Tendinopathy diagnosed?

The diagnosis of the Achilles tendinopathy condition is usually fairly straightforward but we often recommend an Ultrasound scan to confirm the degree of tendinopathy.

How is Achilles Tendonitis treated?

Achilles Tendinopathy Treatment involves firstly identifying and correcting any causative factors and then using painkillers and rest as necessary. Specific physiotherapy stretches and exercises (eccentric programme) and splints may also be recommended. Unfortunately, the condition can often fail to respond to these measures, and we see many patients who have suffered with the condition for over a year and who have been unable to participate in their usual recreational activities and whose daily lives are made difficult because of the pain.

What is the role of Shock Wave Therapy?

In longstanding (chronic) cases that have not responded to the othertreatments, we recommend shock wave therapy as it is a non-invasive, needle-free outpatient procedure that is well tolerated and successful in relieving pain in 80% of cases.

Other tendinopathy treatments are available for chronic tendinopathy, such as PRP (platelet-rich plasma) injections, GTN (glyceryltrinitrate) patches and, as a last resort, surgery. We now rarely have to resort to any of these as we have found SWT to be so successful.

We have found shock wave therapy to be 70-80% successful for achilles tendinopathy treatment, in a wide range of patients; some of who have had the condition for several years.